ON THE BEARS.

It's a big headache--and much more

Hillenmeyer aware caution is critical in treating a concussion

September 21, 2006|BY DAVID HAUGH.

When Bears coach Lovie Smith wanted to talk to Hunter Hillenmeyer last week, the linebacker braced himself for another blow--this one to his psyche.

Hillenmeyer already had suffered a concussion that knocked him out of the season opener against Green Bay in the second quarter, and now he wondered if he had let Smith down because his stay on the sidelines extended into a second game.

After all, nothing about Hillenmeyer looked hurt yet he remained on the team's injury list. That can be a sure way for an NFL player to stay on a different sort of list with his head coach.

"A coach usually wants players who are willing to suck it up and play," said Hillenmeyer. He practiced Wednesday and expects to start at strong-side linebacker Sunday against the Minnesota Vikings.

Hillenmeyer had hoped to return against Detroit, but team doctors put him on a safer, slower road to recovery that he assumed was different than what Smith had mapped out.

"[But] Lovie said, `Don't be a tough guy,"' Hillenmeyer said. "He said, `If your vision's blurred or you can't sleep or you have a headache, say something, because this is not the kind of thing we want you to fight through."'

But fight through is what NFL players do, right? The Bears' training room, like so many in the NFL, treats players on a daily basis whose answer to holding off injuries is tape and toughness.

A concussion arouses that same machismo instinct within players. But, as Smith and the Bears showed in handling Hillenmeyer, a brain injury requires anything but the same type of treatment.

There can be no gray area when dealing with injured gray matter: Proceed with caution.

"The difference between a concussion and a muscle injury is that the brain is much more complex," said Mark Lovell, the director of neuropsychological testing for the NFL and director of the University of Pittsburgh Medical Center's Sports Medicine Concussion Program.

Just as complicated are the feelings such an injury stirs within conscientious players such as Hillenmeyer. He is conditioned to play no matter what.

But something about blurry vision and a throbbing head made this injury feel different.

"A lot of times people just try to shake it off because of some age-old thing and at the youngest age of football, they tell you to play through pain," Hillenmeyer said. "But this isn't something you want to do that with."

An educated guy who graduated with a 3.8 grade-point average, Hillenmeyer didn't need to read the 50 articles his mom and girlfriend have sent him the past two weeks to realize how right he was. But what he learned might give pause to any 25-year-old man.

For instance, there's a 2005 study out of the University of North Carolina's Center for the Study of Retired Athletes that found players with three or more concussions were five times more likely to develop the type of mild cognitive impairment that leads to Alzheimer's disease. Or another one that showed the link between depression and NFL players who had suffered three or more concussions.

The league has invested $2 million over the last decade to commission studies and has formed the NFL Committee on Mild Traumatic Brain Injury to help standardize how teams treat concussions.

"I felt good last week, but [the doctors] wanted to err on the side of caution," Hillenmeyer said. "It's not a knee where you can test and [take an] MRI to see what's wrong. A player doesn't know how bad it is if you have a headache. It's so subjective and there are so many different types of people."

Already this season, there are so many different types of examples around the league.

Rams offensive tackle Orlando Pace suffered a concussion after being knocked over after an extra point against the San Francisco 49ers last Sunday and is iffy for this week. Chiefs quarterback Trent Green, still without a timetable for his return, lay 11 minutes on the turf after the Bengals' Robert Geathers hit him in the season opener. Panthers linebacker Dan Morgan still isn't sure when he will return after suffering the fifth concussion of his career in their opener against Atlanta.

Whenever those players return, they will have to pass the same type of psychological exam administered Hillenmeyer before he was allowed back on the field. The questions included everything from asking Hillenmeyer to recall what he ate for dinner the previous night to remembering a series of words that flashed on a computer screen.

"It was like taking the SAT or something," Hillenmeyer said.

A bigger test awaits Sunday when Hillenmeyer returns to a position defined by violence. A linebacker is as likely to use his head on Sundays as a kicker is to use his tee.

"The last thing any football player wants to do is be tentative because they're worried about injuries," Hillenmeyer said. "I'm good to go."